Varicose Veins Treatment

We can divide the treatment of varicose veins into two as non-surgical varicose treatment and surgical varicose treatment.
 
Among the non-surgical varicose treatments, there are varicose veins treatment with socks, varicose veins treatment with drugs, sclerotherapy and skin laser and radiofrequency treatments.

Non-Surgical Varicose Veins Treatments
 
Varicose veins treatment with sclerotherapy method; It is the process of entering the varicose vein with the help of a needle and closing the problematic vein with the help of a drug called sclerosant.

It is generally used in the treatment of capillary and medium-sized varicose veins. The foam method is nothing different from sclerotherapy. This time it is the injection of the drug into the vein by foaming.

It is generally used in the treatment of very dense capillary and medium-sized varicose veins. The form in which the drug is administered, liquid or foam, depends on the size and density of the vein.

Contrary to popular belief, foam treatment is not an effective, trouble-free and permanent treatment in major vascular insufficiency, that is, in the treatment of large varicose veins that require surgery.
 
Sclerotherapy and Foam Treatment Treatment Steps
 

• First, it is ensured that there is no main vessel insufficiency or that there is treatment with ultrasound.

• No anesthesia is required.

• The determined veins are entered with a needle and the sclerosant drug is injected in liquid or foam form with the needle.

• The drug disrupts the inside of the vein and the body closes this damaged vein.

• This shutdown is a time-consuming process. The vein does not disappear as soon as the drug is given, over time, the body destroys the damaged vein and makes it invisible. This period is about 4-6 weeks.

• The procedure can be done in outpatient conditions. The patient continues his daily life in the same way after the procedure.

 
Skin Lasers and Skin Radiofrequency Treatments
 
It is the treatment performed with the help of needles that transmit rays or waves over the skin for very very thin capillaries that cannot be performed with sclerotherapy. It can be a little painful.

Local anesthetic creams can be used to prevent pain. Reactions such as blushing are seen on the same day. It goes away after a few hours.

Then crusting occurs. It will pass in 3-4 weeks. Re-treatment to the same area as it can pass in a single session.

When we look at the surgical varicose treatment solutions, it is based on the deactivation of the large vein that creates the insufficiency, that is, the valves that do not work.

Here, we come across different treatments such as varicose vein surgery, laser or radiofrequency varicose surgery, glue-adhesive technique varicose surgeries, Moca-Mechanical Chemical Intravascular closure technique, removal of side branch varices-phlebectomy, ligation of connecting veins-perforating vein ligation, which are classically performed with open technique.
 
Varicose Veins Treatment with Laser or Radiofrequency Catheter
 

• First, the vessel map is obtained with Doppler USG. The vessels to be intervened are determined. It is marked before the operation.

• No general anesthesia or waist numbing is required. The patient is awake. To eliminate the stress of the operating room, the patient can be sedated. All procedures are performed under local anesthesia.

• The determined veins are accessed with a needle and a laser fiber or radiofrequency catheter is inserted into the vein. It is advanced to the point of the beginning of the leak (most often in the groin or behind the knee).

• Anesthesia is performed with a local anesthetic solution, which we call “tumescent anesthesia”, along the vein.

• With the energy given by the laser or radiofrequency catheter, heat is emitted and the catheter is slowly withdrawn and removed. Thus, it is ensured that the vein is closed on itself without removing it.

• After the operation, the patient can stand up immediately. He can walk. After 4-5 hours, he can go home and return to his daily work.

• It is enough to wear compression stockings for 10-15 days.

 
It is the first recommended varicose surgery technique in the world-class literature. It is a painless, comfortable technique with the lowest probability of recurrence in experienced hands.
 
Varicose Vein Surgery Technique with Glue / Adhesive
 

• First, the vessel map is obtained with Doppler USG. The vessels to be intervened are determined. It is marked before the operation.

• No general anesthesia or waist numbing is required. The patient is awake. To eliminate the stress of the operating room, the patient can be sedated. All procedures are performed under local anesthesia.

• The determined veins are accessed with a needle and the glue catheter is inserted through the vein. It is advanced to the point of the beginning of the leak (most often in the groin or behind the knee).

• Anesthesia is not required throughout the vein.

• Adhesive material is slowly injected through the catheter and pressure is applied to the vein with the ultrasound probe, so that the vein is adhered to and closed. The catheter is slowly withdrawn and removed.

• After the operation, the patient can stand up immediately. He can walk. After 4-5 hours, he can go home and return to his daily work.

• Then it is not necessary to wear compression stockings.

 
Although it may seem easier, it is one of the techniques that requires serious experience. It may not be suitable for every patient.
 
Open Technique Varicose Surgeon
 
Although we do not use the classical surgical technique much today, it is still the best method for varicose veins that have lost the chance of surgery with advanced laser or radiofrequency.
 

• It is performed under general anesthesia or numbing the waist down. With a small incision made at the level of the groin and knee, the problematic vein is separated from the connection points. The wire is pulled by wrapping it around and pulled out.

• You can stay in the hospital for 1 night after the operation. You can walk as soon as the effect of the anesthesia wears off.

• You are discharged the next day. You can return to his daily work in 2-3 days.

• The pain is very mild. It is never in a way that hinders movement or walking.

• Then it is enough to wear compression stockings for 2-3 weeks.

Removal of Side Branch Varices, Phlebectomy
 
After one of the above techniques is applied to the main large vein, large worm-like varicose veins, if any, are pulled out with the help of a tool like a crochet hook, through very small incisions, or rather from the holes.

It is done with local anesthesia. In experienced hands, sewing is not even necessary. It is the most permanent and radical treatment for large varicose veins.

It greatly reduces sclerotherapy sessions. After the operation, the patient gets rid of those bad images immediately. It is combined with the above surgical techniques when necessary. It does not affect post-operative comfort.
 
Your doctor decides which of all these surgical techniques is suitable for you, based on your body structure, other accompanying health parameters, vessel diameters, vessel course, and areas of insufficiency. Sometimes several techniques need to be used in the same patient.
 
If there is a main vascular insufficiency, treatments performed only for aesthetic purposes without eliminating it are not permanent treatments.

Aybanu Gokcen MD underlines important information regarding the treatment of varicose veins: "There is no such thing as the best treatment. There is the most appropriate treatment for the patient."